AREA PROFILE -- PIERCE                                      
                                                                                                
                                                                                                
        DEMOGRAPHIC DATA                                                                        
                                                                                                
                                U.S. CENSUS ESTIMATES, 2004                                     
                                                                                                
                 PIERCE -     7,692                     NEBRASKA - 1,747,214                    
                                                                                                
                                                                                                
                                 POPULATION BY AGE AND RACE/ETHNICITY                           
                        PIERCE                                     NEBRASKA                     
 AGE         PERCENT        NATIVE                                         NATIVE               
GROUP   TOTAL       BLACK AMERICAN ASIAN HISPANIC  TOTAL  PERCENT  BLACK AMERICAN ASIAN HISPANIC
  0-4     405  5.3      1      2       2       3  122,049   7.0     6,566  1,726   2,087  15,560
 5-14   1,095 14.2      3      5       3      20  236,970  13.6    14,021  3,332   3,652  24,538
15-24   1,263 16.4      2     10       5      12  266,314  15.2    13,893  3,368   4,811  21,847
25-44   1,787 23.2      2     10       8      16  473,637  27.1    22,127  4,736  11,084  40,755
45-64   1,879 24.4      1      2       1       5  416,441  23.8    13,444  2,631   5,077  13,752
65-74     551  7.2      0      1       0       0  111,352   6.4     2,767    471     821   2,126
75-84     501  6.5      0      1       1       0   84,541   4.8     1,454    213     325   1,044
 85+      211  2.7      0      0       0       0   35,910   2.1       549     93      76     359
 <18    2,094 27.2      4     11       7      28  446,083  25.5    24,698  6,261   7,104  47,141
 65+    1,263 16.4      0      2       1       0  231,803  13.3     4,770    777   1,222   3,529
                                                                                                
                                                                                                
                               POPULATION BY GENDER AND RACE/ETHNICITY                          
                        PIERCE                                     NEBRASKA                     
             PERCENT        NATIVE                                         NATIVE               
GENDER  TOTAL       BLACK AMERICAN ASIAN HISPANIC  TOTAL  PERCENT  BLACK AMERICAN ASIAN HISPANIC
Men     3,859 50.2      4     14       6      35  863,628  49.4    37,128   8,068  13,719 65,048
Women   3,833 49.8      5     17      14      21  883,586  50.6    37,693   8,502  14,214 54,933
 15-17    265           0      1       2       2   42,285           1,986    590     663   3,127
                                                                                                
                                                                                                
                                    POPULATION BY RACE/ETHNICITY                                
                                                                                                
                             PIERCE                              NEBRASKA                       
         RACE/ETHNICITY     NUMBER   PERCENT                     NUMBER   PERCENT               
         White               7,616     99.0                   1,609,056     92.1                
         Black                   9      0.1                      74,821      4.3                
         Native American        31      0.4                      16,570      0.9                
         Asian                  20      0.3                      27,933      1.6                
                                                                                                
         Hispanic               56      0.7                     119,981      6.9                
                                                                                                
         Minority *            131      1.7                     250,577     14.3                
                                                                                                
    * Minority Population = Total Population - White, Not Hispanic Population                   
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                  HOUSEHOLDS BY TYPE, 2000 CENSUS                               
                                                                                                
                                      PIERCE                    NEBRASKA                        
                                                                                                
                                      % OF      % OF              % OF      % OF                
                                      HOUSE-    HOUSE-            HOUSE-    HOUSE-              
                                      HOLDS     HOLDS             HOLDS     HOLDS               
                                     WITH NO   WITH AT           WITH NO   WITH AT              
                                    CHILDREN   LEAST 1          CHILDREN   LEAST 1              
      FAMILY TYPE                      <18    CHILD<18             <18    CHILD<18              
   Married couples                     32.8      30.6              28.6      25.6               
   Male householders                    1.0       1.8               1.3       2.0               
   Female householders                  1.9       3.8               2.6       6.5               
   Male householder nonfamilies        12.5       0.3              15.2       0.3               
   Female householder nonfamilies      15.3       0.0              17.8       0.1               
                                                                                                
                        HOUSEHOLDS BY TYPE AND RACE/ETHNICITY, 2000 CENSUS                      
                                                                                                
                                % OF HOUSEHOLDS               % OF HOUSEHOLDS                   
                                                  Native                     Native             
                                Total White Black American Total White Black American           
     Families                   71.9  71.8    .  100.0     66.6  66.2  65.0  74.3               
      Married Couples           63.4  63.5    .   50.0     54.2  55.4  28.8  35.4               
        W/Children < 18         30.6  30.5    .   50.0     25.6  25.4  16.7  24.0               
      Single Parent Families     8.5   5.4    .   33.3     12.4   7.2  28.7  32.6               
        Male householder         2.8   2.8    .    0.0      3.3   3.0   5.4   8.8               
          W/Children < 18        1.8   1.8    .    0.0      2.0   1.8   3.6   6.7               
        Female Householder       5.7   5.5    .   50.0      9.1   7.8  30.8  30.1               
          W/Children < 18        3.8   3.6    .   33.3      6.5   5.4  25.1  25.9               
     Nonfamily households       28.1  28.1    .    0.0     33.4  33.7  34.9  25.7               
                                                                                                
                                                                                                
                                  % OF HOUSEHOLDS             % OF HOUSEHOLDS                   
                                  Asian  Hispanic Minority *  Asian  Hispanic Minority *        
     Families                      50.0     92.3     80.0      66.9     77.3     70.2           
      Married Couples               0.0     92.3     60.0      53.7     54.0     42.1           
        W/Children < 18             0.0     84.6     53.3      33.0     40.7     28.3           
      Single Parent Families       50.0      0.0     16.7       8.3     17.9     21.8           
        Male householder            0.0      0.0      0.0       4.5      9.6      7.1           
          W/Children < 18           0.0      0.0      0.0       2.2      6.3      4.6           
        Female Householder         50.0      0.0     20.0       8.7     13.7     21.0           
          W/Children < 18          50.0      0.0     16.7       6.1     11.6     17.2           
     Nonfamily households          50.0      7.7     20.0      33.1     22.6     29.9           
                                                                                                
    * Minority Population = Total Population - White, Not Hispanic Population                   
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                        EDUCATIONAL ATTAINMENT BY RACE/ETHNICITY, 2000 CENSUS                   
                                Percent of persons 25 years and older                           
                                                                                                
                                     PIERCE                     NEBRASKA                        
                                                  Native                     Native             
                                Total White Black American Total White Black American           
                                                                                                
     Less than 9th grade         8.0   7.9   0.0  40.0      5.4   4.5   5.3   9.0               
     9th to 11th grade           7.4   7.5   0.0  13.3      8.0   7.3  16.0  15.1               
     High school diploma        42.2  42.1   0.0  46.7     31.3  31.8  31.2  33.7               
     Some college, no degree    20.5  20.5   0.0   0.0     24.3  24.5  27.4  26.1               
     Associate degree            8.7   8.8   0.0   0.0      7.3   7.5   5.9   7.4               
     Baccalaureate degree        9.4   9.4 100.0   0.0     16.5  17.0  10.5   6.2               
     Graduate or professional    3.9   3.8   0.0   0.0      7.3   7.4   3.6   2.6               
     degree                                                                                     
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                Percent of persons 25 years and older                           
                                                                                                
                                     PIERCE                     NEBRASKA                        
                                                                                                
                                                                                                
                                  Asian  Hispanic Minority *  Asian  Hispanic Minority *        
                                                                                                
     Less than 9th grade           23.1     16.7     17.8      10.8     34.2     17.9           
     9th to 11th grade              0.0      8.3      5.5      11.9     19.2     16.3           
     High school diploma           46.2     75.0     52.1      17.1     21.3     25.5           
     Some college, no degree       15.4      0.0     11.0      13.3     13.9     20.1           
     Associate degree               0.0      0.0      0.0       5.4      2.9      4.8           
     Baccalaureate degree          15.4      0.0      9.6      21.8      5.9     10.0           
     Graduate or professional       0.0      0.0      4.1      19.8      2.7      5.5           
     degree                                                                                     
                                                                                                
    * Minority Population = Total Population - White, Not Hispanic Population                   
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
        SOCIAL INDICATORS                                                                       
                                  PER CAPITA INCOME, 2000 CENSUS                                
                                                                                                
                                 PIERCE                NEBRASKA                                 
                                $15,980                $19,613                                  
                                                                                                
                         MEDIAN HOUSEHOLD INCOME, 2002 CENSUS ESTIMATES                         
                                                                                                
                                 PIERCE                NEBRASKA                                 
                                $34,582                $41,978                                  
                                                                                                
                        PERCENT BELOW 100% POVERTY, 2002 CENSUS ESTIMATES                       
                                                                                                
                                 PIERCE                NEBRASKA                                 
     5-17 Years of Age                9.4                    10.8                               
     Total Population                10.5                    10.0                               
                                                                                                
                 PERCENT BELOW 100% POVERTY BY RACE/ETHNICITY, 2000 CENSUS *                    
                                                                                                
                                 PIERCE                NEBRASKA                                 
     White                           11.6                     8.2                               
     Black                           25.0                    27.4                               
     Native American                 68.8                    33.0                               
     Asian                           13.6                    12.8                               
     Hispanic                        22.9                    20.4                               
 * A '.' indicates the population estimate of the racial/ethnic group is zero.                  
                                                                                                
                     PERCENT OF WORKERS UNEMPLOYED, DEPT. OF LABOR, MAY, 2004                   
                                                                                                
                            PIERCE                     NEBRASKA                                 
                    # UNEMPLOYED   % OF WORKERS   # UNEMPLOYED % OF WORKERS                     
                           157         3.6          39,368       4.0                            
                                                                                                
                                  HIGH SCHOOL DROPOUT RATE, 2003-2004                           
                                                                                                
                                 PIERCE                   NEBRASKA                              
     % of 7-12th Grade Member-                                                                  
     ship Who Drop Out of School      0.5                       1.9                             
                                                                                                
                             NEW FAMILIES AT RISK BY RACE/ETHNICITY, 2000-2004                  
        First Births to Unmarried Women Under Age 20 with Less Than H.S. Education              
                                                                                                
                                 PIERCE                   NEBRASKA                              
                      # BIRTHS    % OF 1ST BIRTHS*  # BIRTHS  % OF 1ST BIRTHS*                  
     Total                 9            5.7          4,398          9.0                         
     White                 9            5.7          3,351          7.7                         
     Black                 .             .             653         24.4                         
     Native American       0             .             232         36.9                         
     Asian                 .             .              39          2.9                         
     Hispanic              0             .           1,034         19.3                         
          * Percentage based on at least 6 first births.                                        
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
         REPORTS AND/OR ARRESTS FOR VIOLENT CRIME, DUI AND OTHER DRUG CHARGES, 2004             
                                                                                                
                                       PIERCE                     NEBRASKA                      
                                        NUMBER RATE/1,000      NUMBER RATE/1,000                
     Total Arrests                         257   33.4          94,648   54.2                    
     Arrests for violent crimes *            6    0.8           1,596    0.9                    
     Reported forcible rape offenses         2    0.3             195    0.1                    
     Arrests for DUI                        87   11.3          14,163    8.1                    
     Drug law violation arrests             43    5.6          10,898    6.2                    
    *Violent crimes include: murder, forcible rape, robbery and aggravated assault.             
                                                                                                
        JUVENILE ARRESTS(<18) FOR VIOLENT CRIMES, DUI AND DRUG LAW VIOLATIONS, 2004             
                                                                                                
                                       PIERCE                     NEBRASKA                      
                                        NUMBER RATE/1,000      NUMBER RATE/1,000                
     Total Arrests                         19     9.1         14,867    33.3                    
     Arrests for violent crimes *           0     0.0            224     0.5                    
     Arrests for DUI                        1     0.5            348     0.8                    
     Drug law violation arrests             2     1.0          1,150     2.6                    
    *Violent crimes include: murder, forcible rape, robbery and aggravated assault.             
                                                                                                
                           CHILD PROTECTION AND SAFETY, CY 2004                                 
                                                                                                
                                       PIERCE                     NEBRASKA                      
                                        NUMBER RATE/1,000      NUMBER RATE/1,000                
                                                                                                
     Average number of children                                                                 
     in out-of-home care *                17     7.9          7,160    15.9                     
    *Children in temporary or permanent out-of home care (foster care, group homes or           
     other residential care facilities).                                                        
                                                                                                
           CHILDREN INVOLVED IN SUBSTANTIATED CASES OF ABUSE/NEGLECT, CY 2003                   
                                                                                                
                                            PIERCE               NEBRASKA                       
     Rate per 1,000 Children < Age 19            5.5                 8.6                        
                                                                                                
                   DOMESTIC VIOLENCE, JULY 1, 1999 - JUNE 30, 2000                              
                                       PIERCE                     NEBRASKA                      
                                        NUMBER RATE/1,000      NUMBER RATE/1,000                
     Number of Crisis Calls                                                                     
     Received by Multi-County Agency    4,487     55.8       108,312     63.3                   
     Total New Contacts for                                                                     
     Multi-County Agency                  893     11.1        24,249     14.2                   
     PIERCE MULTI-COUNTY AREA ALSO INCLUDES:                                                    
               Antelope, Boyd, Holt, Knox, Madison, Stanton                                     
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
        HEALTH STATUS                                                                           
                                                                                                
                                                                                                
                                LEADING CAUSES OF DEATH, 2000-2004                              
                             Age-Adjusted Death Rates per 100,000 Population                    
                                                                                                
                                                                            NEBRASKA            
                                                        NEBRASKA           NATIVE               
                        PIERCE            NEBRASKA      YEAR 2010   BLACK AMERICAN HISPANIC     
CAUSE OF DEATH             DEATHS  RATE  DEATHS  RATE   OBJECTIVE   RATE    RATE    RATE        
Heart Disease (#1)            196 316.4  20,262 205.1      --       245.6   276.0  110.6        
Cancer -- All Sites (#2)       90 188.9  16,798 182.0    147.0      255.2   201.9  117.8        
  Lung/Bronchus/Trachea        17  38.2   4,444  49.1     39.0       81.5    60.1   24.6        
  Breast (Female)               7  29.1   1,224  23.8     20.7       41.3    32.8    9.7        
  Prostate                      5  21.5     943  25.7     25.9       48.8    18.5    9.3        
Cerebrovascular (#3)           43  65.7   5,385  54.0     47.4       87.0    55.2   28.8        
Unintentional Injuries (#4)    24  54.2   3,457  37.6     19.4       25.2    92.6   34.9        
  Motor Vehicle                12  30.4   1,469  16.6     12.0        9.7    43.8   17.4        
Chronic Lung Disease (#5)      15  28.0   3,746  39.4      --        39.2    54.7   12.4        
                                                                                                
Suicide                         5  12.4     922  10.7      8.2        4.6     9.1    4.2        
Homicide                        1   2.4     259   3.0      2.0       20.3    11.9    6.6        
                                                                                                
Diabetes Related               40  71.3   6,933  72.6     25.0      162.8   260.9  109.3        
Tobacco Related                71 133.9  12,886 137.2      --       184.1   192.6   75.5        
Alcohol Related                18  37.4   3,255  35.5      --        41.9   137.3   41.2        
Work Related Accidents          3   7.6     209   2.4      --         0.4     0.9    2.5        
                                                                                                
All Causes                    454 811.6  75,953 789.1      --     1,110.5 1,269.2  559.0        
                                                                                                
    NOTE: Age adjusted rates are based on the 2000 U.S. census standard.                        
                                                                                                
                                                                                                
                                                                                                
                                  CANCER INCIDENCE, 1999-2003                                   
                      Age-Adjusted Incidence Rates per 100,000 Population                       
                                                                                                
                    PIERCE                                   NEBRASKA                           
                                                                      Native                    
                     Total    Total           Total    Total   Black American Hispanic          
Cancer Type         # Cases   Rate           # Cases   Rate    Rate    Rate     Rate            
All Sites               211   437.2           42,194   474.2   474.5   393.6   292.3            
                                                                                                
Lung & Bronchus          27    60.0            5,572    62.7    93.3    62.7    39.3            
Breast (Female)          32   130.3            6,278   131.8   102.2    56.9    57.2            
Prostate                 35   159.4            6,470   165.9   197.9   146.3    57.0            
Colorectal               30    56.4            5,366    59.1    61.9    47.7    44.5            
                                                                                                
    NOTE: Age adjusted rates are based on the 2000 U.S. census standard.                        
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
        LEADING REASONS FOR HOSPITALIZATION (NEBRASKA OCCURRANCE ONLY), 2003-2004               
                     Age-Adjusted Hospital Discharge Rates per 100,000 Population               
                                     PIERCE                 NEBRASKA         PERCENT            
    CONDITION/INJURY              # DISCHARGES  RATE # DISCHARGES  RATE     DIFFERENCE          
                                                                                                
     All Conditions/Injuries           1,620  9,634.00  359,031  9,837.00      -2.1             
     Pregnancy/Childbirth                315  2,541.00   89,507  2,465.00       3.1             
     All Injuries                        221  1,184.00   55,504  1,509.00     -21.5             
     Diabetes Related Diseases           238  1,191.00   46,921  1,277.00      -6.7             
     Heart Disease                       190    945.00   37,934  1,014.00      -6.8             
     Digestive Diseases                  150    784.0    29,464    808.0       -3.0             
     Musculoskeletal Diseases             75    445.0    23,783    659.0      -32.5             
     Psychosis/Mental Health              31    210.0    17,125    492.0      -57.3             
     Pneumonia                           111    547.0    14,664    386.0       41.7             
     Genitourinary Diseases               64    390.0    14,656    411.0       -5.1             
     Cancer                               65    354.0    11,800    322.0        9.9             
     Fractures                            37    180.0     9,998    261.0      -31.0             
     Other Respiratory Diseases           42    248.0     9,145    246.0        0.8             
     Tobacco Related Diseases             56    278.0     9,566    257.0        8.2             
     Surgical/Medical Complications       40    208.0     8,506    236.0      -11.9             
     Cerebrovascular Disease              64    301.0     8,131    214.0       40.7             
     COPD                                 73    401.0     7,578    208.0       92.8             
     Alcohol Related Diseases             11     57.0     2,405     67.0      -14.9             
                                                                                                
    Leading Causes of Injury                                                                    
     Falls                                46    209.0    11,318    291.0      -28.2             
     MV Accidents                          6     35.0     2,218     62.0      -43.5             
     Self-Inflicted                        6     40.0     1,754     50.0      -20.0             
     Other Unintentional                   5     27.0     1,215     33.0      -18.2             
     Poisoning                             1      4.0       592     16.0      -75.0             
     Struck/Pierced by Object              1      3.0       609     17.0      -82.4             
     Overexertion                          2     14.0       480     13.0        7.7             
     Environmental                         5     34.0       513     14.0      142.9             
     Assault                               1      6.0       442     12.0      -50.0             
                                                                                                
                                LEADING PAYER TYPE FOR HOSPITALIZATION, 2003-2004               
                                                                                                
                                     PIERCE                 NEBRASKA         PERCENT            
    PAYER TYPE                      DISCHARGES    %   DISCHARGES     %      DIFFERENCE          
     Commercial                          631     39.0   168,501     46.9      -16.8             
     Medicare                            845     52.2   131,141     36.5       43.0             
     Medicaid                            136      8.4    50,769     14.1      -40.4             
     Self-Pay                              4      0.2     3,460      1.0      -80.0             
     Other State/Federal                   4      0.2     5,160      1.4      -85.7             
                                                                                                
    NOTE: Age adjusted rates are based on the 2000 U.S. census standard.                        
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                     INCIDENCE OF AIDS, 2000-2004                               
                                                                                                
                                   PIERCE                            NEBRASKA                   
                                       *Rate                            Rate                    
                                        1.3                              3.8                    
                                                                                                
       * County or HD rates are not available.  The above rates are the rate per                
         100,000 population of the Service Area containing the county or HD.                    
                                                                                                
                 INCIDENCE OF RESOURCE INTENSIVE COMMUNICABLE DISEASES, 2003                    
                                                                                                
                                   PIERCE                            NEBRASKA                   
                                       Rate                             Rate                    
      West Nile Virus (WNV)            89.2                              112                    
      Chronic Hepatitis C               0.0                             64.2                    
      TB                                0.0                              1.6                    
                                                                                                
       Note: Rates are per 100,000 Population.                                                  
                                                                                                
               INCIDENCE RATES OF SEXUALLY TRANSMITTED DISEASES BY RACE/ETHNICITY               
                                                                                                
                          PIERCE                                     NEBRASKA                   
                                   2000-2004                                2000-2004           
          2004   2004          Native        His-    2004   2004          Native        His-    
AGE GROUP Total  White  Black American Asian panic   Total  White  Black American Asian panic   
 All Ages   13.0   13.1    0.0    0.0 1111.1  363.6   424.4  193.7 2847.6  903.3  166.6  518.3  
 < 18        0.0    0.0    0.0    0.0 3333.3    0.0   226.2   83.9 1616.4  383.6   67.7  125.0  
 > 17       18.0   18.1    0.0    0.0    0.0  833.3   455.9  207.6 3181.6 1086.7  163.3  667.2  
STD TYPE                                                                                        
Gonorrhea    0.0    0.0    0.0    0.0    0.0    0.0    65.8   19.1 1025.7  127.1   19.6   62.9  
Chlamydia   13.0   13.1    0.0    0.0 1111.1  363.6   301.3  146.5 1695.1  722.6  131.0  413.7  
  Female    25.8   26.1    0.0    0.0 1538.5  952.4   433.6  223.1 2278.7 1163.2  198.0  666.3  
Herpes       0.0    0.0    0.0    0.0    0.0    0.0    42.0   18.6   82.7   18.7    7.3   23.5  
                                                                                                
       Note: Rates are per 100,000 Population.                                                  
                                                                                                
                             ESTIMATED PREVALENCE OF DEMENTIA, 2004                             
                                                                                                
                              PIERCE                            NEBRASKA                        
                Rate *        # of Persons **                   # of Persons **                 
    Age 65-74    10%                 55                            11,135                       
    Age 75-84    20%                100                            16,908                       
    Age 85+      47%                 99                            16,878                       
                                                                                                
 * Source: Prevalence estimates - Alzheimer's Association.                                      
** Number of persons is the Alzheimer prevalence times the 2004 U.S. Census estimate.           
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
        MATERNAL AND CHILD HEALTH AND WELL-BEING                                                
                                                                                                
                           INFANT MORTALITY BY RACE/ETHNICITY, 2000-2004                        
                                                                                                
                          PIERCE                NEBRASKA                                        
                           INFANT             INFANT          NEBRASKA YEAR 2010                
    RACE/ETHNICITY         DEATHS  RATE       DEATHS  RATE         OBJECTIVE                    
    White                      1   2.3          670   5.9             4.5                       
    Black                      0   0.0          121  16.9             4.5                       
    Native American            0   0.0           31  14.4             4.5                       
    Asian                      0   0.0           10   3.5             4.5                       
    Total                      1   2.2          838   6.6             4.5                       
    Hispanic                   0   0.0          109   6.9             4.5                       
                                                                                                
       Note: Rates are per 1,000 live births.                                                   
                                                                                                
    VERY LOW (<1500 GR) AND LOW (<2500 GR) BIRTH WEIGHT BY RACE/ETHNICITY, 2000-2004            
                                                                                                
                                                              NEBRASKA YEAR 2010                
                          PIERCE                NEBRASKA           OBJECTIVE                    
    WEIGHT                 NUMBER  RATE       NUMBER  RATE          RATE                        
    Very Low - All Births      7  15.6        1,611  12.7             9.0                       
    Low - All Births          16  35.6        8,821  69.4            50.0                       
          White               16  36.0        7,431  65.8            50.0                       
          Black                0   0.0          897 125.1            50.0                       
          Native American      0   0.0          145  67.2            50.0                       
          Asian                0   0.0          221  77.7            50.0                       
          Hispanic             0   0.0          976  62.0            50.0                       
                                                                                                
       Note: Rates are per 1,000 live births.                                                   
                                                                                                
                     NUMBER OF INFANTS BORN WITH BIRTH DEFECTS, 1999-2003                       
                                                                                                
                               PIERCE                NEBRASKA                                   
                           # of      % of          # of      % of                               
                          Infants Total Births    Infants Total Births                          
    Infants with birth                                                                          
     defects                   16      3.6         4,534        3.6                             
                                                                                                
                          TEEN AGE BIRTHS BY AGE AND RACE/ETHNICITY, 2000-2004                  
                   PIERCE                            NEBRASKA                                   
    Age of Mother  10-17        15-17            10-17        15-17                             
                NUMBER   %   NUMBER   %       NUMBER   %   NUMBER   %                           
    All Births      7   1.6      7   1.6      3,715   2.9  3,583   2.8                          
    White           7   1.6      7   1.6      2,792   2.5  2,718   2.4                          
    Black           0   0.0      0   0.0        631   8.8    586   8.2                          
    Native Amer     0   0.0      0   0.0        184   8.5    179   8.3                          
    Asian           0   0.0      0   0.0         36   1.3     35   1.2                          
    Hispanic        0   0.0      0   0.0        881   5.6    846   5.4                          
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
               PERCENTAGE OF PREGNANT WOMEN WHO SMOKE DURING PREGNANCY, 2000-2004               
                                                                                                
    NUMBER OF CIGARETTES                                      NEBRASKA YEAR 2010                
    SMOKED PER DAY           PIERCE               NEBRASKA         OBJECTIVE                    
    1-10                         15.4              10.4                 --                      
    11-20                         4.5               2.8                 --                      
    21+                           0.5               0.6                 --                      
    Unknown                       0.0               0.3                 --                      
                                                                                                
    TOTAL                        20.3              14.1                 2.0                     
                                                                                                
    Note: These figures are based on pregnant women who have a live birth.                      
                                                                                                
                PERCENT BEGINNING PRENATAL CARE IN THE FIRST TRIMESTER, 2000-2004               
                                                                                                
                                                              NEBRASKA YEAR 2010                
    RACE                     PIERCE               NEBRASKA         OBJECTIVE                    
    White                        87.4              84.7                90.0                     
    Black                         0.0              70.5                90.0                     
    Native American               0.0              68.3                90.0                     
    Asian                         0.0              82.2                90.0                     
                                                                                                
    Total                        87.5              83.2                90.0                     
                                                                                                
    Hispanic                      0.0              69.3                90.0                     
                                                                                                
    Note: These figures are based on pregnant women who have a live birth.                      
                                                                                                
                                                                                                
                                                                                                
                                                                                                
       CHILDREN AGED 19-35 MONTHS UP-TO-DATE ON IMMUNIZATIONS, July 2003 - June 2004            
                                                                                                
                                                                          NEBRASKA              
                                   PIERCE             NEBRASKA             CURRENT              
                                                                          OBJECTIVE             
    % of children receiving      County-level data                                              
    4 DTP/3 Polio/1 Measles-       not avaliable        82.4%                90%                
    Containing Vaccine/3 Hib/                                                                   
    3 Hepatitis B                                                                               
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
        RISK FACTOR PREVALENCE                                                                  
                                                                                                
       BRFSS RISK FACTOR PREVALENCE ESTIMATES (ADULTS AGE 18 OR OLDER), 2000-2004               
                                                                                                
                                    PIERCE              NEBRASKA         NEBRASKA               
                                          * % WITH          % WITH      YEAR 2010               
    RISK FACTOR                     (N)   BEHAVIOR   (N)   BEHAVIOR     OBJECTIVE               
    Obese (body mass                                                                            
       index 30 or higher)          864     22.8   23,583    22.4          15%                  
    No leisure-time                                                                             
     physical activity              907     30.4   24,965    25.0          15%                  
    Currently smoke                                                                             
     cigarettes                     907     19.4   24,932    21.1          12%                  
    Chronic drinking                                                                            
     60+/Mo Men - 30+/Mo Women      791      3.1   21,579     4.8          --                   
    No health insurance             904     18.5   24,932    11.9           0%                  
    Could not see physician in                                                                  
     past 12 months due to cost     617     10.2   16,873     8.4           4%                  
                                                                                                
    Mammogram                                                                                   
     in past two                                                                                
     years (Ages 40+)               314     69.8    6,913    75.5          75%                  
    Immunization rates (65+)                                                                    
     Flu shot past 12 months        294     67.3    6,210    71.5          90%                  
     Pneumonia immunization         291     58.8    6,123    63.2          90%                  
                                                                                                
    General health good to                                                                      
     excellent (self-reported)      906     87.4   24,924    87.4          --                   
    Ten or more days in past 30                                                                 
     days health not good                                                                       
      Physical health               723      9.0   20,236     9.7          --                   
      Mental health                 727      8.3   20,276     9.5          --                   
                                                                                                
    * Note: With the exception of Sarpy, county percentages are the                             
      Health District percentage containing the county.  Douglas and                            
      Lancaster counties are their own Health District                                          
                                                                                                
                           YOUTH RISK BEHAVIORS, GRADES 9-12, 2003                              
                                                                 NEBRASKA YEAR 2010             
                                          NEBRASKA       U.S.           OBJECTIVE               
    Smoking at least once in                                                                    
     past 30 days                           24%          35%               15%                  
                                                                                                
    Drank alcohol on at least                                                                   
     1 of past 30 days                      47%          50%               --                   
                                                                                                
    Binge drinking (5+ drinks                                                                   
     on an occasion) in past                                                                    
     30 days                                32%          32%               25%                  
                                                                                                
    Drinking and driving                                                                        
     in past 30 days                        21%          13%               10%                  
                                                                                                
    Riding in a motor vehicle with                                                              
     someone who has been drinking                                                              
     alcohol (past 30 days)                 39%          33%               30%                  
                                                                                                
    Ever used marijuana in lifetime         35%          49%               --                   
                                                                                                
    Used marijuana in past 30 days          18%          27%               5%                   
                                                                                                
    Ever used cocaine (any form) in                                                             
        lifetime                             7%          10%               --                   
                                                                                                
    Ever used inhalants (sniffed glue,                                                          
     breathed contents of aerosol spray                                                         
     cans, inhaled paints/sprays to get                                                         
     high) in lifetime                      12%          15%               --                   
                                                                                                
                                                                                                
            RACIAL/ETHNIC RISK FACTOR PREVALENCE ESTIMATES, AGES 18 & OLDER, 2000-2004          
                                                                                                
                                              State-Level Data Only                             
                                                                                                
                                                                                                
                                      African   Native   Asian   Hispanic                       
     Risk Factor                      American American American American  White                
                                                                                                
     Obese (BMI 30 or higher)           34       39       11       24       23                  
                                                                                                
     No leisure-time physical activity  34       29       25       44       25                  
                                                                                                
     Currently smoke cigarettes         27       44       20       18       23                  
                                                                                                
     General health good to excellent   77       76       89       73       86                  
                                                                                                
     No health insurance                20       27       14       45       11                  
                                                                                                
     Could not afford to see physician  17       21       13       17        9                  
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
        ENVIRONMENTAL DATA                                                                      
                                                                                                
       NITRATE LEVELS IN COMMUNITY WATER SYSTEMS, 2000-2004                                     
                                                                                                
               PIERCE                   NEBRASKA                                                
                                                                                                
               % OF                       % OF                                                  
      # OF   COMM POP AVERAGE    # OF   COMM POP AVERAGE                                        
     COMMNTY DRINKING NITRATE   COMMNTY DRINKING NITRATE    NEBRASKA YEAR 2010                  
     SYSTEMS  >10 PPM  LEVEL*   SYSTEMS  >10 PPM  LEVEL*        OBJECTIVE                       
                                                               < 1% who drink                   
       17       0.5     4.8       1351     1.0     3.0         water >10 ppm                    
                                                                                                
                                                                                                
     * Weighted average.  Weight is the number served by the water system.                      
                                                                                                
                                                                                                
                                                                                                
                                                                                                
           FLUORIDE LEVELS IN COMMUNITY WATER SYSTEMS, 2004                                     
                                                                                                
                PIERCE                                 NEBRASKA                                 
                                                                                                
                                 % OF                                    % OF                   
              SYSTEMS          COMM POP               SYSTEMS          COMM POP                 
      # OF     WITH   COMMTY % DRINKING       # OF     WITH   COMMTY % DRINKING                 
     COMMNTY FLUORIDE OF 2000  FLUORIDE      COMMNTY FLUORIDE OF 2000  FLUORIDE                 
     SYSTEMS .75-1 PPM CENSUS .75-1 PPM      SYSTEMS .75-1 PPM CENSUS .75-1 PPM                 
                                                                                                
        5        1     51.7      20.0          607       97    81.1       67.5                  
                                                                                                
                                                                                                
    Nebraska Year 2010 Objective: at least 80% of people served by community                    
                                  water systems receive optimal levels of                       
                                  fluoride (.75-1 ppm).                                         
                                                                                                
                                                                                                
                                                                                                
               HIGH BLOOD LEAD LEVELS IN CHILDREN UNDER AGE 6, 2002-2004                        
                                                                                                
              PIERCE                    NEBRASKA                                                
                                                                                                
                 # w/High     %          # w/High      %    NEBRASKA YEAR 2010                  
     LEAD LEVEL Blood Lead Tested       Blood Lead  Tested      OBJECTIVE                       
                                                                                                
     >9ug/dL         3        3.5          1846       3.3      0% (>9ug/dL)                     
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
        AVAILABILITY OF SERVICES                                                                
                                                                                                
                           HEALTH PROFESSIONALS IN PRACTICE, 2003                               
                                                                                                
                                     PIERCE                      NEBRASKA                       
                                            # Persons                  # Persons                
                                  # of      Served per       # of      Served per               
    PROFESSION              Practitioners Practitioner Practitioners Practitioner               
                                                                                                
General/Family Practice            4           1928          677          2569                  
Internal Medicine                  0              .          227          7662                  
Pediatrics                         0              .          162         10736                  
OB/Gynecology                      0              .          143         12163                  
Psychiatry                         0              .          140         12424                  
Physician Assistant                2           3857          445          3909                  
Nurse Practitioner                 0              .          329          5287                  
Licensed Practical Nurse          62            124         6337           274                  
Dentist                            3           2571         1084          1605                  
Registered Nurse                  69            112        18257            95                  
Note: Persons served was calculated using 2003 census estimates.                                
                                                                                                
 RN's (2002) & Primary Care Physicians (2004) by Race/Ethnicity                                 
                             # RN's # Primary Care Physicians # RN's # Primary Care Physicians  
 White                           31              4            15729           1023              
 Black                            .              0              166             15              
 Native American                  .              0               54              5              
 Asian                            .              0              117             43              
 Hispanic                         .              0              183             25              
 Other Race/Ethnicity/Unknown     .              0               85              4              
                                                                                                
                       FEDERAL SHORTAGE AREA DESIGNATIONS, 2003                                 
                                                                                                
                                     PIERCE                      NEBRASKA                       
        HPSA                           All                         Part                         
        MUA/MUP                        Part                        Part                         
                                                                                                
                            EMERGENCY SERVICES, 2003                                            
                                                                                                
        SERVICE                           PIERCE                 NEBRASKA                       
    Ambulance services                           4                 394                          
                                                                                                
                          AVAILABILITY OF TRANSPORATION, 1998                                   
                                                                                                
                 PUBLIC TRANSPORTATION AVAILABLE IN PIERCE ?  YES .                             
                                                                                                
            COMMUNITIES SERVED BY PUBLIC TRANSPORTATION IN PIERCE :                             
                                                                                                
                    Plainview                                                                   
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
                                                                                                
        SERVICE UTILIZATION DATA                                                                
                                                                                                
                                                                                                
                     MEDICAID ELIGIBILITY AND EXPENDITURES, FY 2003                             
                                                                                                
                           PIERCE                         NEBRASKA                              
                        TOTAL PERSONS    % OF        TOTAL PERSONS    % OF                      
                        ELIGIBLE(#)   ELIGIBLES      ELIGIBLE(#)   ELIGIBLES                    
                                                                                                
    Medicaid                  807        100.0         205,498        100.0                     
       Aged                   130         16.1          18,449          9.0                     
       Blind & Disabled        77          9.5          26,534         12.9                     
       ADC Children           531         65.8         134,743         65.6                     
       ADC Adults              69          8.6          25,772         12.5                     
                                                                                                
                                                                                                
                                                                                                
                             PIERCE                        NEBRASKA                             
                              TOTAL    % OF TOTAL      TOTAL    % OF TOTAL                      
                             DOLLARS    MEDICAID      DOLLARS    MEDICAID                       
                              ($000)    DOLLARS        ($000)    DOLLARS                        
                                                                                                
    Medicaid                  $4,461     100.0     $1,280,005     100.0                         
       Aged                    2,193      53.4        353,582      29.4                         
       Blind & Disabled          865      21.0        432,011      36.0                         
       ADC Children              810      19.7        319,452      26.6                         
       ADC Adults                242       5.9         95,724       8.0                         
                                                                                                
               MEDICAID EXPENDITURES BY TYPE OF SERVICE PROVIDED, FY 2003                       
                                                                                                
                             PIERCE                        NEBRASKA                             
                              TOTAL    % OF TOTAL      TOTAL    % OF TOTAL                      
                             DOLLARS    MEDICAID      DOLLARS    MEDICAID                       
                              ($000)    DOLLARS        ($000)    DOLLARS                        
                                                                                                
    All Medicaid              $4,461     100.0     $1,280,005     100.0                         
                                                                                                
    Medicaid Fee-for-Service   3,625      81.3        970,707      75.8                         
       Hospital--Inpatient       566      12.7        257,282      20.1                         
       Hospital--Outpatient      280       6.3         75,892       5.9                         
       ICF Mentally Retarded      27       0.6         50,253       3.9                         
       Nursing Facility        1,496      33.5        271,975      21.2                         
       Physician                 436       9.8        100,083       7.8                         
       Dental                    129       2.9         33,337       2.6                         
       Prescribed Drugs          692      15.5        181,885      14.2                         
                                                                                                
    Other Medicaid (Includes                                                                    
       Capitated Payments)       836      18.7        309,298      24.2                         
                                                                                                
                                                                                                
                   UTILIZATION OF SERVICES BY PROGRAM, FY 2004                                  
                                                                                                
                             PIERCE                        NEBRASKA                             
                             AVERAGE    AVERAGE       AVERAGE    AVERAGE                        
                             MONTHLY    PAYMENT       MONTHLY    PAYMENT                        
                          PARTICIPANTS    ($)      PARTICIPANTS    ($)                          
                                                                                                
    Aid to Dependent              14   $351.06*        12,237   $353.16*                        
       Children (ADC)                                                                           
    Food Stamp Program           295    $74.65**      111,435    $79.42**                       
                                                                                                
     *  Average payment per family.                                                             
     ** Average payment per person.                                                             
                                                                                                
                NUMBER OF PERSONS SERVED BY PUBLIC HEALTH PROGRAMS                              
                                                                                                
    SERVICE PROVIDED                 PIERCE                        NEBRASKA                     
                                                                                                
    WIC, UNDUPLICATED PERSONS SERVED, 2004                                                      
       Pregnant women seen                           6            4,527                         
       Breastfeeding clients seen                    7            5,609                         
       Postpartum women seen                        49           10,951                         
       Infants seen                                 40            9,521                         
       Children seen                               110           39,835                         
                                        Native                             Native               
       Total WIC clients     Total  Black Am  Asian Hispanic    Total  Black Am  Asian Hispanic 
       seen in 2004           212     0     3     0      1     70,449 7,664 1,316 1,296 20,674  
                                                                                                
    Reproductive health, 2004                       77           42,421                         
                                                                                                
              NURSING HOME AND HOSPITAL LONG-TERM CARE OCCUPANCY, 2004                          
                                                                                                
                                            PIERCE                NEBRASKA                      
    Nursing Home and Hospital                                                                   
    Long-Term Care Facilities                                                                   
         Number of licensed beds                   114           17,130                         
         Occupancy rate                           71.6             82.7                         
                                                                                                
    Persons Aged 65 and Older                                                                   
    Living in Nursing Homes or                                                                  
    Hospital Long-Term Care                                                                     
    Facilities                                                                                  
         Number                                     77           12,710                         
         Percent of population                     6.0              5.5                         
           aged 65 and older                                                                    

Statistical Profiles